Comparison of clinical treatment of traumatic cervical spinal cord injuries with acute respiratory failure treated by high-flow nasal cannula therapy and non-invasive positive pressure ventilation

Abstract

Objective To compare the clinical efficacy of high-flow nasal cannula oxygen therapy (HFNC) with non-invasive positive pressure ventilation (NPPV) in patients with traumatic cervical spinal cord injury complicated with acute respiratory failure (ARF). Methods A prospective randomized controlled trial was performed in EICU of the First Affiliated Hospital of Zhengzhou University from May 2016 to January 2018. One hundred sixty-eight consecutive patients with traumatic cervical spinal cord injury complicated with ARF, who did not respond to conventional oxygen therapy, were assigned to the HFNC or NPPV treatment group sequenced by the random number table. The baseline clinical characteristics of randomized participants and respiratory frequency (RR), PaCO2, mean arterial pressure (MAP) at 1, 12, 24, 48 h after treatment were evaluated. Comfortable scale, tracheal intubation rate within 28 d, duration of mechanical ventilation, length of stay in ICU and mortality rate were compared as well. Results There was no significant differences in baseline clinical characteristics, such as sex, age. between the two groups (P>0.05). RR and PaCO2 were lower in the HFNC group at all time point. In addition, the HFNC group had significantly lower PaCO2 than the NPPV group at 24 and 48 h after treatment (P 0.05). Conclusions In addition to the superior efficacy in improving respiratory function and shortening length of stay in ICU, HFNC was well tolerated by patients with traumatic cervical spinal cord injury complicated with ARF, and could be recommended in clinical practice. Key words: Traumatic cervical spinal cord injury; High-flow nasal cannula oxygen therapy; Non-invasive positive pressure ventilation; Respiratory failure